Presidents Can Have Migraines

This liberal feminist never thought she’d be defending Tea Party darling Michele Bachmann, but that was before the media pile-on regarding her migraine headaches—all triggered by a Daily Caller piece that suggested the episodes make her unfit for the presidency.

The article, by Jonathan Strong, is rife with scaremongering, anonymously sourced accusations. “She carries and takes all sorts of pills,” says one of her former advisers. “Prevention pills. Pills during the migraine. Pills after the migraine, to keep them under control. She has to take these pills wherever she goes.” It also reports that three times over the past year, Bachmann checked in to either a hospital or an urgent-care center to seek pain relief.

“Some close to Bachmann fear she won’t be equal to the stress of the campaign, much less the presidency itself,” Strong writes.

As a lifelong migraineur—I’ve suffered from the severe headaches, which run in my family, since I was a toddler—I have nothing but sympathy for Bachmann. Unlike regular tension headaches, migraines occur when the blood vessels in the head become engorged, causing the trademark throbbing, pulsing, and stabbing sensations associated with the condition. The pain is often located on one side of the head, face, or neck; my own migraines tend to cluster around the outer corner of my left eye. From there, the pain shoots out toward my temple and down to the nape of my neck.

Each episode must be treated with prescription drugs—Advil, Tylenol, or Excedrin won’t make the grade—and can last from a few hours to several days. There are some common migraine triggers, including hunger, stress, alcohol, and the hormonal changes that occur throughout a woman’s monthly cycle. But many migraines come on completely mysteriously, no matter how careful a sufferer has been to avoid triggers. Perhaps that is why I found the Daily Caller article so infuriating; it seemed to suggest that Bachmann was to blame for her own medical disability, in that she is somehow unable to deal with normal, day-to-day stresses, such as a staffer quitting his job or a flight delay.

Because the majority of migraine sufferers are women, it isn’t uncommon for us to face some sexism. If we weren’t so damn hysterical, this offensive thinking goes, maybe we wouldn’t work ourselves up into such a tizzy.

I don’t know Bachmann, so I don’t know whether she is particularly anxious or high-strung (though many high-achieving, type-A people are). The fact is, we all have bodily reactions to the stresses in our lives—some folks get stomach aches, others rush out for a drink, some retreat to bed to catch up on sleep. As The Daily Beast reported last year, even our seemingly unflappable current president sometimes takes prescription medication to help him deal with the jet lag his job entails.

Throughout history, many highly effective, successful people have been migraine sufferers, including Claude Monet, Sigmund Freud, Charles Darwin, Monica Seles, Dwyane Wade, and at least two presidents, Thomas Jefferson and Ulysses S. Grant. In fact, some of Grant’s infamous alcoholic episodes may have actually been migraines. Alternatively, it’s possible that the Civil War hero attempted to dull the pain of his migraines with alcohol, during a time before sophisticated medical treatments were available.

Thankfully, migraine sufferers have come a long way since then. The American Migraine Foundation estimates that nearly 40 million people, or 12 percent of the population, experience migraines at least occasionally. For chronic sufferers like Bachmann and me, dealing with the pain can be a challenge. In a New York Times follow-up to the Daily Caller article, Bachmann’s staff reported that she takes three types of medication to control her migraines: a triptan drug to bring down the swelling of the blood vessels, an anti-nausea pill, and a daily prophylactic medication to prevent the episodes.

I also have prescriptions for each of these types of drugs, so maybe I can demystify exactly what the experience of having a migraine is like—and explain why it doesn’t prevent someone from being good at her job, even if that job is highly stressful.

Here’s the truth about living with this condition: We migraine sufferers can get a lot done, even when we’re in pain.

Triptan pills are used to treat acute migraine pain. I take a triptan called Treximet, which also includes a dose of the painkiller naproxen, the active ingredient in Aleve. If I’m careful about swallowing the Treximet at the very beginning of a migraine and then taking it easy for a few minutes—perhaps closing my eyes in a dark room and drinking a glass of water—I’ll usually feel better within an hour. The only side effects I’ve noticed are that my skin becomes sensitive to the touch, and I sometimes feel a bit lightheaded. I wouldn’t do strenuous exercise after taking Treximet, but the drug has never prevented me from traveling, making important phone calls, reading, writing, or attending an event. I often take one of these pills on the go without interrupting my routine at all.

Sometimes I’ll combine the Treximet with a tiny anti-nausea pill called metoclopramide. I’ve never had a single side effect from this drug. And rarely—for the very worst migraine episodes—I will follow up by taking a Tylenol with codeine. This is the medication you’ll take home with you after a dental procedure or other minor surgery. I’m able to work quite well after taking it, though I sometimes describe it as making me feel “languid”—a bit physically lazy and kind of lightheaded, though certainly fully intellectually functional.

In my early 20s, I went from suffering from a few migraines per month to experiencing the painful headaches two, three, and sometimes even four times per week. This isn’t unusual; many female migraine patients find the condition worsens during their peak reproductive years. Since then, in consultation with a neurologist, I’ve tried a number of prophylactic, or preventive, migraine treatments, as Bachmann uses. The first was atenolol, a drug most commonly prescribed to treat high blood pressure. It seemed to work for a while, but because my blood pressure is already naturally low, I felt weak and shaky while I was taking the medication. Sitting up too fast after lying down could make stars appear in front of my eyes. One morning, before eating breakfast or having coffee, I ran to catch a bus to work. After making the short sprint, I had to sit down with my head between my legs; I almost blacked out. Atenolol wasn’t the right drug for me.

Next I tried Topamax, an anti-seizure medication that has helped many migraine sufferers. Unfortunately, this drug, too, left me with uncomfortable side effects, most notably a pervasive nervous feeling every morning. I just couldn’t shake it, and gave up on Topamax after a few months. Then, about a year ago, my neurologist gave me a prescription for nortriptyline, an antidepressant that, by disrupting brain chemistry, can sometimes relieve migraines. For about six months I was ecstatic—the incidence of my migraines went way down. But over time, the effectiveness wore off.

This week I’m trying something totally new: Botox injections in certain pressure points in my head and neck where I feel frequent migraine pain. (Yep, this bizarre-sounding idea is FDA-approved.)

Sure, I’m frustrated that I have yet to find a treatment that truly prevents my migraines. I bet Michele Bachmann feels the same. But here’s the truth about living with this condition: We migraine sufferers can get a lot done, even when we’re in pain. I chanted Torah at my bat mitzvah with a migraine. I’ve done TV appearances while having a migraine, interviewed politicians while having a migraine, and sat through dinner parties—making polite conversation—while having a migraine.

Last Friday I worked until midnight at The Daily Beast/Newsweek helping to proof pages for the print magazine. I had a migraine.

It’s perfectly conceivable to me that a president could function with migraines, especially given the constant, first-rate medical care he or she would enjoy. I hope Michele Bachmann continues to fight back against the absurd suggestion that her disability disqualifies her from the highest office in the land—even as I hope that she doesn’t get anywhere near that office, not because of her migraines, but because of her policy positions.